The Reverse Tummy Tuck (reverse abdominoplasty) is a specialized cosmetic procedure designed to address skin laxity and excess fat specifically in the upper abdomen. Unlike the traditional tummy tuck that focuses on the area below the navel, the reverse method targets the region between the belly button and the breasts or chest. This technique involves removing surplus skin and pulling the remaining tissue upwards to achieve a smoother, more contoured appearance in the upper torso. This approach is highly focused for individuals whose concerns are concentrated on the upper abdominal wall, often after significant weight loss or due to natural aging.
Procedure Overview and Incision Placement
The fundamental difference between this procedure and a standard tummy tuck lies in the direction of skin tightening and the location of the incision. In a reverse tummy tuck, the surgeon excises excess skin and fat from the upper abdomen and then pulls the skin upward toward the breast fold to create the desired tension and contour. This contrasts with a traditional abdominoplasty, where skin is pulled downward toward the pubic area.
The incision placement is strategically designed to minimize visible scarring, as it is typically hidden within the inframammary fold, which is the natural crease located beneath the breasts. For patients who are not undergoing simultaneous breast procedures, the incision may run along the lower chest area. This placement allows the scar to be easily concealed by a bra, bikini top, or the natural shadow of the breast.
The procedure focuses primarily on skin and fat excision and the upward redraping of tissue. While muscle repair, or plication, is a common component of a traditional tummy tuck to correct diastasis recti, it is less frequently performed during a reverse abdominoplasty. However, if a patient has muscle separation in the upper abdomen, a surgeon may still address this during the procedure to achieve a flatter abdominal wall.
Determining Ideal Candidacy
The ideal candidate for a reverse tummy tuck is an individual with significant skin laxity concentrated almost entirely in the upper abdomen, above the navel. This specific pattern of loose skin often results from massive weight loss or prior surgery, such as a traditional tummy tuck that did not fully resolve upper abdominal issues. Candidates should be in good overall health, maintain a stable weight, and be non-smokers to ensure optimal healing.
This procedure is also frequently performed in conjunction with breast surgeries, such as a breast lift or reduction, because the incisions can be combined, reducing the total amount of scarring. The reverse method is particularly beneficial for those who have relatively good tone and minimal excess skin in the lower abdomen.
Patients who have substantial skin laxity below the navel or significant diastasis recti (abdominal muscle separation) in the lower abdomen are generally not suitable candidates for this procedure alone. These individuals typically require a traditional or full abdominoplasty to address the entire midsection, as the reverse technique is highly targeted to the upper region.
Post-Operative Care and Healing
Recovery from a reverse tummy tuck often involves a shorter downtime compared to a full abdominoplasty, generally requiring about one to two weeks before returning to a non-strenuous job. Patients should expect swelling and mild to moderate discomfort in the upper abdomen, which is usually managed effectively with prescribed pain medication. Swelling and bruising in the upper torso are common and will gradually subside over several weeks.
A compression garment is a standard part of post-operative care, specifically designed to cover the chest and upper abdomen to minimize swelling and provide support to the surgical site. Due to the location of the incision beneath the breasts, patients must strictly follow restrictions on movement, particularly avoiding heavy lifting or strenuous arm movements for at least four to six weeks.
Light walking is encouraged soon after the surgery to promote circulation and prevent blood clots, but any activity that places strain on the upper abdomen or chest must be avoided. Final results become apparent as residual swelling resolves over several months. Scar care protocols, such as using silicone sheets or gels, are important for optimizing the incision’s appearance.